Use of bioabsorbable pin in innominate osteotomy for correction of developmental dyplasia of the hip

Abstract

Innominate Osteotomy first described by Salter is one of the commonest procedures performed for treatment of Developmental Dysplasia of the Hip (DDH) in children. We recently described a less invasive technique for Innominate Osteotomy, which significantly reduces the operation time without compromising outcome (J Pediatr Orthop B. 2010 Jul;19(4):318–22). As part of the evolution of this procedure we now routinely use bioabsorbable pins (INION OTPS PIN, made from co-polymers of L-lactic acid, D-lactic acid and trimethylene carbonate) instead of K-wires to secure the graft.

We prospectively followed-up 120 consecutive cases done using bioabsorbale pins over a 2 year period. The surgical technique was as described in our less invasive innominate osteotomy paper. Average age at surgery was 24 months (18–52) with mean follow-up period of 15 months (6–24 months). The mean preoperative acetabular index was 36.2^o. Our results show a mean acetabular index of 18.7^o (P< 0.0001) at latest follow-up with no loss of correction. We recorded three superficial wound infections (one MRSA), all resolved uneventfully. There was no foreign body reaction.

The use of bioabsorbable pins eliminates the need for a second anaesthetic to remove the pins with significant cost benefit without compromising outcome.